Five major healthcare IT vendors have agreed to adopt an interoperability framework consisting of legal terms, policy requirements, technical specifications and governance processes—fostering cooperation that’s designed to simplify system-to-system data sharing.

The vendors—athenahealth, eClinicalWorks, Epic, NextGen Healthcare and Surescripts—are the first implementers of the Carequality Interoperability Framework, a collection of documents that will be used to create the structure for data sharing for their customers and to enable nationwide health information exchange.

"The Carequality framework exists to provide a way for the participants in those various networks to connect to one another," says Dave Cassel, director of Carequality, an initiative of The Sequoia Project, a public-private coalition of stakeholders, which includes payers, providers, and vendors and which is committed to solving the challenges of interoperability through consensus building.

“The Carequality framework exists to provide a way for the participants in those various networks to connect to one another,”says Cassel.

Cassel describes the framework as "first and foremost, a governance structure [that provides] a way for organizations legally to understand the rights and obligations that they have for one another." Using the common structure eliminates the need to develop lengthy and expensive one-off legal agreements each time one organization wants to share data with another.

The framework also includes a standardized set of technical specifications and requirements to foster interoperability. "It doesn’t do a whole lot of good if you have that shared governance but you don’t actually speak the same language," Cassel contends. In addition, a directory is available that enables participating organizations to know who is accessible under the framework and how to communicate with them.

Document queries are "just the first of what we envision to be many technical use cases,” Cassel says of the Carequality Interoperability Framework. The five health IT vendors have signed contracts agreeing to follow the framework’s "rules of the road," says Cassel, with the goal of increasing connectivity as service providers across healthcare organizations. The Carequality Connection Terms put the burden on vendors to ensure that their customers are following the framework’s principles so that their systems interconnect with all the customers of participating organizations.

"The fact that they’re all vendors is a little bit of an accident of timing," explains Cassel, who asserts that providers, payers and government agencies are also being sought as framework implementers. "As we move forward, I think you'll see other types of networks. I do have a verbal commitment from one health information exchange for example, and we’re having conversations with other organizations. And, the impact will only grow as more organizations sign on."

Initially, the five implementers of the Carequality Interoperability Framework will focus on query-based exchange of clinical documents. However, Cassel emphasizes that the framework is not restricted to just document queries.

"It's just the first of what we envision to be many technical use cases," he concludes. "We have work that's underway, for example, planned for 2016 that will look into imaging content exchange and the first steps for more integrated care coordination workflows across organizational boundaries."

One health IT vendor that is conspicuously absent from the first group of companies implementing the framework is Cerner, which, in a written statement, said it supports the free flow of data across the care continuum, regardless of geographic or technological boundaries.

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